Maternal Health Service

Our organization is informed by an empirical study done by Veronica K. Juma (one of the founders) on the distribution patterns of ABO and Rhesus Incompatibility blood group among women and their spouses attending Guru Nanak Ramgharia Sikh Hospital in Nairobi in order to promote social awareness, and safe blood transfusion among the population. The study further sought to assess the knowledge of couples at Guru Nanak Ramgharia Sikh Hospital regarding ABO and Rh incompatibility and their associated risks to mother and child. It was a retrospective study that involved a review of medical records of patients tested for ABO and Rhesus compatibility and incompatibility at Guru Nanak Ramgharia Sikh Hospital in Nairobi, Kenya between the years 1990 and 2022. The study further employed a cross-sectional design where 20 couples were randomly sampled and interviewed on their knowledge regarding with ABO and Rh incompatibility and its associated risks to mother and child. The study established that cases of ABO and Rh Incompatibility are prevalent. Regarding patients’ awareness of ABO and Rh incompatibility, the study found out that out of the 20 randomly sampled respondents, only seven respondents were aware of ABO and Rh Incompatibility and its associated risks to mother and child. Because of the apparent lack of awareness of the Rh associated risks to mother and child among couples, increased incidences of spontaneous abortion, stillbirth and postnatal mortality have been recorded in Kenya. 

Based on the findings of this study, our organization's primary focus is to help respond to lack of awareness on ABO and Rh Incompatibility cases in Kenya.

• We respond to prevalent cases of spontaneous abortion, stillbirth and postnatal mortality due to ABO and Rhesus Incompatibility through awareness creation among couples in Kenya on ABO and Rhesus Incompatibility Risks to mother and child.

• We document cases of ABO and Rhesus incompatibility from maternity hospitals records to analyse the prevalence of ABO and Rhesus incompatibility cases while mapping the cases in Kenya.
• With the documented cases, we provide a database to maternity hospitals that serve the most marginalized communities in Samburu, Machakos, Laikipia and Turkana Counties.

Our target population includes the most marginalized communities that are hard to reach through technological infrastructure. These include communities in Turkana, Samburu, Machakos and Laikipia. These communities are also having high levels of illiteracy and would always explain infant deaths and still births as curses. The concept of Rhesus incompatibility is not known to majority of the villagers here. 

Our organization heavily relies on Community Based Participatory Research. In this design, the views, ideas and input of the community is highly taken into consideration. The Team Leader is a native of Laikipia and has worked in Maralal and Samburu for many years. Moreover, the Team Leader is fluent in the native languages and culture of the target population. The principal method of community engagement is through organized couple forums where couples are able to narrate their experiences of still births, abortions and infant deaths. From these narratives, awareness of Rhesus incompatibility is anchored.

This solution is based on an existing data about Rhesus incompatibility cases in Kenya and the existing community ideas about still births, abortions and infant deaths. Second, this organization has already passed the formative stage and has already conducted a series of community based participatory forums on rhesus compatibility and incompatibility awareness. Third, this organization has a clear structure of operation. Therefore, it is a prototype rather than a concept.

Currently, the organization has already served 148 people.

Our vision is to scale up our health solution to cover the entire country and subsequently move on to the entire sub-saharan region. However, we currently lack the necessary capacity that can scale up this project. By capacity, we hear mean that we require mentorship and advice on how this solution can be scaled up. Second, we also envision coming up with a national Rhesus Data Bank. This data bank will become a platform for statistical sharing with maternity hospitals. Hospitals will be able to obtain rhesus data from this platform and use this data for any couple who visits the hospitals for anti-natal clinics. This implies that we need a very large-scale data collection capacity. However, this vision of scaling up this project into a National Rhesus Data Bank requires technical support. We therefore, seek technical support from Solve. Third, our health solution requires financial support to enable us create grassroots awareness and scale the solution to cover the entire country. 

First, our solution is creating an awareness of Rhesus incompatibility and its effects on mother and newborns. This has not been done in Kenya before. Second, our solution seeks to scale up the innovation to a national rhesus data bank, which currently does not exist in Kenya. This solution holds the key to positively impact the lives of communities in Kenya as it will significantly reduce the negative effects of rhesus incompatibility among couples. Infant deaths shall be reduced as data about couple rhesus shall be available. This solution will surely change the dynamics of blood transfusion in Kenya from a tedious process of testing to simply obtaining data from our project. 

Our first impact goal is create awareness about rhesus compatibility and incompatibility among couples. We plan to achieve this impact goal through grassroots community forums and expert input from medical practitioners. 

Our second impact goal is to scale up this solution to data collection stage. We plan to develop (with conjunction with the Kenya Ministry of Health) a data bank where couples' data would be stored and shared with maternity hospitals.

Our foremost target is to reduce Maternal mortality ratio which is currently is 414/100,000 live births in Kenya. 

Our target is aligned with the UN Sustainable Development Goal  of reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030.

Our solution is informed by Health Belief Model which revolves around threat perception and behavioral evaluation in health seeking attitudes. The threat perception includes perceived susceptibility to the disease or health problem and the perceived severity of its consequences. By contrary, behavioral evaluation includes the benefits or efficacy of the recommended health behavior, and the costs of, or barriers to the recommended health behavior. Moreover, the model proposes that when appropriate beliefs are held, the activation of health behavior is done by cues to action including a diverse range of triggers, such as individual perceptions of the disease, social influence, and health education campaigns or interventions. Finally, the model recognizes the general health motivation of individuals, or their concern about health matters (Abraham, 2016).

In other words, the Health Belief Model states that the individual’s action is influenced by their perception of the illness, either in the level of severity, the consequences, or the potential benefits of the action weighed against the physical, psychological, and financial costs in following the recommended action. The HBM is a means to identify perceptions of seriousness, susceptibility, benefits and barriers that can explain the need to engage in a particular  preventive behavior assuming that information related to the disease is accessible to everyone. However, the model recognizes behavior modifiers such as culture, education level, past experience, skills and motivation. 

In its application to this solution, Health Belief Model enables our organization to individual perceptions of stillbirths and infant deaths. This perception, we have found in our engagement with the communities, to be influenced by culture which explains stillbirths as curses. Moreover, the Health Belief Model enables our solution to conduct health education campaigns for awareness creation on rhesus incompatibility.

Currently, we capitalize on the use of SMS. Majority of the communities we are working with are able to have access to SMS. This technology we are using to send reminders about scheduled community forums and pass on key messages about reporting of infant deaths, and stillbirths.

Diversity: Our leadership team is composed of staff from diverse ethnic communities. We also encourage diversity by incorporating staff of various professional backgrounds.

Equity: Our organization is designed in such a way  that we provide people of all backgrounds an opportunity to benefit from our programs.

Inclusion: We value our team, we respect our team, we value and respect the communities in which we are working. 

We capitalize on the social business model. In this model, we identify our clients to be couples. We provide value to the couples by providing a forum of information sharing, learning and exchange. 

First, we hope to bring money to fund our work through donations particularly for the community engagement for awareness creations.

Second, we hope to apply for grants to scale up the project in data collection and establishing a data bank.

Third, after the data bank is established, we will sell the data to maternity hospitals across the country. This will help in the running of our work. 

We have received donations in the past to fund the health education campaigns. The donations were received from individual community members.